| NPI | 1114458676 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 18347) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL M250-6209-0841) | 
| Enumeration Date | 2017-03-24 | 
| Last Update Date | 2020-12-11 |